Care Manager RN (Scarborough)

Opportunities at Northern Light Health , in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind:Caring. Connecting. Growing together.

TheCare Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients.Develops and maintains collaborative relationships with all members of the healthcare team.Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Schedule: Full-Time position with the ability to work 8 weekends a year.

Location : 175 Foreriver Parkway, Portland, ME

Primary Responsibilities:

• Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
• Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate
• Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
• Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
• Communicates telephonically and electronically with outpatient providers in an effort to enhance the continuum of care
• Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelines
• Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
• Assumes responsibility for Health System required continued education and owns professional growth
• Performs tasks of a clinical nature within scope of assigned duties and clinical expertise
• Communicate effectively in both oral and written form, as appropriate for the needs of the audience
• Performs other duties as assigned or required

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage